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Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review 预览
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作者 Christoph Kolja Boese Philipp Lechler +3 位作者 Michael Frink Michael Hackl Peer Eysel Christian Ries 《世界临床病例杂志》 2019年第14期1825-1836,共12页
BACKGROUND Increasing numbers of total joint arthroplasties and consecutive revision surgery are associated with the risk of periprosthetic joint infections (PPJI). Treatment of PPJI is complex and associated with imm... BACKGROUND Increasing numbers of total joint arthroplasties and consecutive revision surgery are associated with the risk of periprosthetic joint infections (PPJI). Treatment of PPJI is complex and associated with immense socio-economic burden. One treatment aspect is parenteral antiinfective therapy, which usually requires an inpatient setting [Inpatient parenteral antibiotic therapy (IPAT)]. An alternative is outpatient parenteral treatment [Outpatient parenteral antibiotic therapy (OPAT)]. To conduct a health economic cost-benefit analysis of OPAT, a detailed cost analysis of IPAT and OPAT is required. So far, there is a lack of knowledge on the health economic effects of IPAT and OPAT for PPJI. AIM To review an economic comparison of IPAT and OPAT. METHODS A systematic literature review was performed through Medline following the PRISMA guidelines. RESULTS Of 619 identified studies, 174 included information of interest and 21 studies were included for quantitative analysis of OPAT and IPAT costs. Except for one study, all showed relevant cost savings for OPAT compared to IPAT. Costs for IPAT were between 1.10 to 17.34 times higher than those for OPAT. CONCLUSION There are only few reports on OPAT for PPJI. Detailed analyses to support economic or clinical guidelines are therefore limited. There is good clinical evidence supporting economic benefits of OPAT, but more high quality studies are needed for PPJI. 展开更多
关键词 Antibiotic THERAPY OUTPATIENT PARENTERAL antibiotic THERAPY INPATIENT PARENTERAL antibiotic THERAPY Cost analysis PERIPROSTHETIC joint infection PARENTERAL
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关注干眼的系统治疗方法 预览
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作者 晋秀明 章悦 《中华实验眼科杂志》 CAS CSCD 北大核心 2019年第3期218-223,共6页
干眼是多因素综合作用引起的眼表疾病,其特征是泪膜稳态失衡,眼表微环境改变,进而导致眼表的不适症状,其发病机制包括泪膜不稳定、泪液高渗透压、眼表炎症与损伤以及角膜神经感觉异常。干眼严重影响患者的工作和生活质量。随着科技的进... 干眼是多因素综合作用引起的眼表疾病,其特征是泪膜稳态失衡,眼表微环境改变,进而导致眼表的不适症状,其发病机制包括泪膜不稳定、泪液高渗透压、眼表炎症与损伤以及角膜神经感觉异常。干眼严重影响患者的工作和生活质量。随着科技的进步,干眼的治疗方法不断更新,轻中度干眼和重度干眼的治疗方法也有所不同。干眼治疗方法的选择因患者病情和治疗机构的条件而异,系统性、规范化、综合性的治疗可明显改善治疗效果。本文系统性总结了传统的与新兴的干眼治疗方法,这些方法操作简单,临床上切实可行,可为不同类型的干眼临床治疗提供参考。 展开更多
关键词 干眼 系统治疗 治疗结局 药物疗法 物理疗法 睑板腺功能障碍
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Stimuli-responsive nitric oxide generator for light-triggered synergistic cancer photothermal/gas therapy
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作者 Xuehui Huang Funeng Xu +3 位作者 Huabo Hou Jianwen Hou Yi Wang Shaobing Zhou 《纳米研究:英文版》 SCIE EI CAS CSCD 2019年第6期1361-1370,共10页
As a minimally invasive local cancer therapy,photothermal therapy (PTT) has aroused intensive interests in recent years.However,the therapeutic effect of PTT is still unsatisfying due to the production of heat shock p... As a minimally invasive local cancer therapy,photothermal therapy (PTT) has aroused intensive interests in recent years.However,the therapeutic effect of PTT is still unsatisfying due to the production of heat shock proteins.Combination therapy has been regarded as a promising strategy to enhance therapeutic efficiency.In this study,a novel intelligent protoporphyrin (PplX)-based polymer nanoplatform is developed for synergistic enhancement of cancer treatment through combined PTT and nitric oxide (NO) therapy.The core of the nanoparticle is composed of closely packed porphyrin-based NO donors and PplX branches of the block copolymer.The prepared nanoparticles exhibit good photothermal conversion capability and high sensitivity to release NO under light illumination.And the produced high localized temperature and intracellular NO concentration could efficiently inhibit cancer cells both in vitro and in vivo.More important,this therapeutic nanoplatform can fundamentally eliminate the emergence of multidrug resistance and overcome the hypoxia microenvironment in tumors because of the absence of chemotherapeutic drugs and the oxygen-independent process,thus opening up new ideas for multifunctional therapeutic agent design for treatment of multidrug-resistant cancer. 展开更多
关键词 PHOTOTHERMAL THERAPY GAS THERAPY micelles combination THERAPY NANOCARRIER
1540nm非剥脱性点阵激光联合水凝胶医用冷敷贴治疗凹陷性痤疮瘢痕疗效研究 预览 被引量:1
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作者 宋婷 罗莉 +1 位作者 贾菲 高琳 《陕西医学杂志》 CAS 2019年第2期241-243,共3页
目的:评价1540nm非剥脱性点阵激光联合水凝胶医用冷敷贴治疗凹陷性痤疮瘢痕的临床疗效。方法:80例凹陷性痤疮瘢痕患者纳入本研究,其中观察组40例、对照组40例。1540nm非剥脱性点阵激光治疗后观察组患者应用水凝胶医用冷敷贴,对照组应用... 目的:评价1540nm非剥脱性点阵激光联合水凝胶医用冷敷贴治疗凹陷性痤疮瘢痕的临床疗效。方法:80例凹陷性痤疮瘢痕患者纳入本研究,其中观察组40例、对照组40例。1540nm非剥脱性点阵激光治疗后观察组患者应用水凝胶医用冷敷贴,对照组应用医用冰袋冷敷。分别对两组患者术后的瘢痕改善、视觉模拟评分(VAS)、疼痛持续时间、结痂时间、脱痂时间及完全愈合时间、不良反应等进行评价分析。结果:两组患者经过治疗后痤疮瘢痕均有不同程度改善,差异无统计学意义(P>0.05)。观察组患者术后VAS评分(2.48±1.15)分、疼痛持续时间(2.43±0.86)h、结痂时间(2.45±1.13)d、脱痂时间(5.20±1.01)d及完全愈合时间(8.50±1.24)d均短于对照组,差异均有统计学意义(P<0.05)。观察组患者不良反应发生率明显低于对照组(P<0.05)。结论:1540nm非剥脱性点阵激光治疗凹陷性痤疮瘢痕后联合应用水凝胶医用冷敷贴,可以有效降低患者治疗后疼痛及灼烧感,缩短红斑持续时间及结脱痂时间,不良反应发生率低。 展开更多
关键词 寻常痤疮 瘢痕 治疗 激光疗法 水凝胶医用冷敷贴 疗效
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Pathological response measured using virtual microscopic slides for gastric cancer patients who underwent neoadjuvant chemotherapy 预览
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作者 Sadayuki Kawai Tadakazu Shimoda +4 位作者 Takashi Nakajima Masanori Terashima Katsuhiro Omae Nozomu Machida Hirofumi Yasui 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第35期5334-5343,共10页
BACKGROUND Although pathological response is a common endpoint used to assess the efficacy of neoadjuvant chemotherapy (NAC) for gastric cancer, the problem of a low rate of concordance from evaluations among patholog... BACKGROUND Although pathological response is a common endpoint used to assess the efficacy of neoadjuvant chemotherapy (NAC) for gastric cancer, the problem of a low rate of concordance from evaluations among pathologists remains unresolved. Moreover, there is no globally accepted consensus regarding the optimal evaluation. A previous study based on a clinical trial suggested that pathological response measured using digitally captured virtual microscopic slides predicted patients’ survival well. However, the pathological concordance rate of this approach and its usefulness in clinical practice were unknown. AIM To investigate the prognostic utility of pathological response measured using digital microscopic slides in clinical practice. METHODS We retrospectively evaluated pathological specimens of gastric cancer patients who underwent NAC followed by surgery and achieved R0 resection between March 2009 and May 2015. Residual tumor area and primary tumor beds were measured in one captured image slide, which contained the largest diameter of the resected specimens. We classified patients with < 10% residual tumor relative to the primary tumorous area as responders, and the rest as non-responders;we then compared overall survival (OS) and relapse-free survival (RFS) between these two groups. Next, we compared the prognostic utility of this method using conventional Japanese criteria. RESULTS Fifty-four patients were evaluated. The concordance rate between two evaluators was 96.2%. Median RFS of 25 responders and 29 non-responders was not reached (NR) vs 18.2 mo [hazard ratio (HR)= 0.35, P = 0.023], and median OS was NR vs 40.7 mo (HR = 0.3, P = 0.016), respectively. This prognostic value was statistically significant even after adjustment for age, eastern cooperative oncology group performance status, macroscopic type, reason for NAC, and T- and Nclassification (HR = 0.23, P = 0.018). This result was also observed even in subgroup analyses for different macroscopic types (Borrmann type 4/non-type 4) and histologi 展开更多
关键词 STOMACH NEOPLASM NEOADJUVANT THERAPY Drug THERAPY Pathology PROGNOSTIC factor
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Preoperative Short-Course Radiation Therapy in Rectal Cancer 预览
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作者 Pham Nguyen Tuong Pham Nguyen Cuong +2 位作者 Le Trong Hung Nguyen Thanh Ai Huynh Thanh Hai 《美中医学:英文版》 2019年第2期100-104,共5页
Purpose:To evaluate the benefits of preoperative short-course radiotherapy in locally advanced rectal cancer.Patients and methods:A prospective study of 30 rectal cancer patients at T3-4M0 stage and ECOG 0-2 performed... Purpose:To evaluate the benefits of preoperative short-course radiotherapy in locally advanced rectal cancer.Patients and methods:A prospective study of 30 rectal cancer patients at T3-4M0 stage and ECOG 0-2 performed preoperative short-course radiation therapy at Hue Central Hospital Vietnam between June 2016 and July 2018,using pelvic 3D-Conformal Radiation Therapy with the total radiation dose being 25 Gy in 5 fractions over five days.Results:Mean age 57.1±13.6 with 46.7%of patients in the range of 41-60 year-old.Male/female ratio:2/1.Tumour stage T3 and T4 was 70%and 30%,respectively;stage III and stage IV was 86.7%and 13.3%,respectively.Positive lymph node rates on endoscopic ultrasound were 85.7%in T3 and 77.8%in T4.Downstaging rate for stage III,T4 and T3 was 65.4%,65.4%and 4.8%,respectively.For upper third of the rectum:100%of T3 stage patients got no downstaging.For middle rectum:downstaging rate for stage III,T4 and T3 was 55.6%,57.1%and 7.1%,respectively.For lower rectum:downstaging rate for stage III,T4 was 50.0%and 100.0%,respectively.No acute toxicity was seen,86.7%of the patients performed laparoscopic sphincter-preserving surgery.Conclusion:For the treatment of locally advanced rectal cancer,neoadjuvant therapy is standard.Preoperative short-course radiation therapy is a reasonable therapeutic option because it demonstrates benefits in tumour downstaging especially for middle and lower rectum. 展开更多
关键词 Rectal cancer short-course RADIATION THERAPY PREOPERATIVE DOWNSTAGING pelvic 3D-conformal RADIATION therapy.
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Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis 预览
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作者 Yi Cheng Nan Huang +3 位作者 Jing Zhao Jianhua Wang Chen Gong Kai Qin 《肿瘤学与转化医学:英文版》 2019年第1期25-29,共5页
Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated... Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group(P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group(P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups(P > 0.05). The radiation doses of Dmax in the small intestine, D1 cc(the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2 cc(the minimum dose to the 2 cc receiving the highest dose) between the two groups(P > 0.05). The incidence of bone marrow suppr 展开更多
关键词 simultaneous integrated dose-increasing INTENSITY-MODULATED radiation therapy late-course dose-increasing INTENSITY-MODULATED radiation therapy cervical cancer COMPLICATED with pelvic lymph node metastasis clinical efficacy safety
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Photodynamic therapy as salvage therapy for residual microscopic cancer after ultra-low anterior resection: A case report 预览
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作者 Si-Qi Zhang Kui-Jie Liu +5 位作者 Hong-Liang Yao San-Lin Lei Zhen-Dong Lei Wen-Jun Yi Li Xiong Hua Zhao 《世界临床病例杂志》 2019年第6期798-804,共7页
BACKGROUND The rate of positive resection margins (R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has b... BACKGROUND The rate of positive resection margins (R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has been reported that photodynamic therapy (PDT) as a remedial treatment for esophageal cancer. Colorectal cancer and esophageal cancer has many similarities, however, PDT as a salvage therapy for rectal cancer is rare. CASE SUMMARY Here, we describe a 56-year-old man who was admitted to the hospital due to a 6- mo history of hemafecia, which had been aggravated for 1 mo. Colonoscopy revealed a 3 × 4 cm ulcerated mass in the rectum 4 cm from the anus. Preoperative pathological examination showed villous adenoma, moderate-tohigh- grade dysplasia, good differentiation, and invasion of the mucosal muscle. The patient had R1 after ultra-low anterior resection, but he refused extended resection and experienced severe liver function impairment after 3 cycles of chemotherapy. Ultimately, the patient underwent PDT to remove R1. After five years of follow-up, there was no liver function impairment, recurrence, metastasis, sexual dysfunction, or abnormal defecation function. CONCLUSION This is the first case worldwide in which R1 of rectal cancer were successfully treated by PDT. 展开更多
关键词 Low RECTAL CANCER Photodynamic THERAPY Positive MICROSCOPIC distal margin SALVAGE THERAPY Removal RESIDUAL MICROSCOPIC CANCER Case report
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Zirconium metal-organic framework nanocrystal as microwave sensitizer for enhancement of tumor therapy
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作者 Yuanwen Zou Wei Zhang +7 位作者 Hongqiao Zhou Changhui Fu Longfei Tan Zhongbing Huang Xiangling Ren Jun Ren Xudong Chen Xianwei Meng 《中国化学快报:英文版》 SCIE CAS CSCD 2019年第2期481-484,共4页
Although surgical resection and chemotherapy were widely applied in tumor therapy, the dysfunction of normal cells resulted in the side effects (such as anorexia, nausea). MW thermal therapy is a non-invasive anticanc... Although surgical resection and chemotherapy were widely applied in tumor therapy, the dysfunction of normal cells resulted in the side effects (such as anorexia, nausea). MW thermal therapy is a non-invasive anticancer strategy under the help of MW sensitizer, with the safety and higher efficacy. Zirconium metal-organic framework nanocubes (ZrMOF NCs) modified with polyethylene glycol, were prepared via one pot method and carbodiimide technique, resulting in their large specific surface area and porosity.Our results showed that non-ion-loaded ZrMOF NCs in 0.9% NaCl solution exhibited better heating effect,higher than that in pure water, due to the robust collision among the ions under MW irradiation. The in vivo experiments confirmed that ZrMOF-PEG NCs + MW group exhibited the higher temperature in the tumor region than that of only MW treatment, suggesting a better MW thermal therapeutic anticancer efficacy. This work provides a new preparation strategy of biosafety nanomaterial as MW sensitizer for enhancing MW thermal anticancer therapy. 展开更多
关键词 MICROWAVE thermal THERAPY ZIRCONIUM metal-organic framework NANOCUBES MICROWAVE SENSITIZER Tumor THERAPY BIOSAFETY
Traditional Chinese medicine five-tone therapy 预览
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作者 Haoran Zhang 《TMR生命研究》 2019年第2期80-83,共4页
From the perspective of the application of medical value orientation music therapy, this paper summarized the ancient Chinese sound therapy, such as shaman music therapy and five-tone therapy. It also compared five-to... From the perspective of the application of medical value orientation music therapy, this paper summarized the ancient Chinese sound therapy, such as shaman music therapy and five-tone therapy. It also compared five-tone therapy with Tibetan Singing bowl music therapy. The ancient music therapy is a kind of medical means which is oriented to the treatment effect. At first, it was mainly based on the music medical behavior of Taoist, and then gradually evolved into the modern treatment application of folk pentatonic therapy. On the basis of inheritance and development of ancient traditional music treatment, contemporary medicine proposed a new individualized music treatment. Therefore, the theory of five-tone therapy has updated the research on traditional Chinese music treatment theory and system, and will provide reference for the establishment of accurate music treatment system in the future. 展开更多
关键词 sound THERAPY music THERAPY TCM fiveelements FIVE TONES
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Does ‘super-responder’ patients to cardiac resynchronization therapy still have indications for neuro-hormonal antagonists? Evidence from long-term follow-up in a single center 预览
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作者 Yi-Ran HU Wei HUA +6 位作者 Han JIN Min GU Xiao-Han FAN Hong-Xia NIU Li-gang DING Jing WANG Shu ZHANG 《老年心脏病学杂志:英文版》 SCIE CAS CSCD 2019年第3期251-258,共8页
Background Whether cardiac resynchronization therapy super-responders (CRT-SRs) still have indications for neuro-hormonal antagonists or not remains uninvestigated.Methods We reviewed clinical data from 376 patients w... Background Whether cardiac resynchronization therapy super-responders (CRT-SRs) still have indications for neuro-hormonal antagonists or not remains uninvestigated.Methods We reviewed clinical data from 376 patients who underwent CRT implantation in Fuwai Hospital from 2009 to 2015 and followed up to 2017.CRT-SRs were defined by an improvement of the New York Heart Association functional class and left ventricular ejection fraction to ≥ 50% in absolute values at 6-month follow-up.All CRT-SRs were assigned into two groups on the basis of whether persistently receiving neuro-hormonal antagonists (NHA)(defined as angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers and β-blockers) after 6-month follow-up and then we compared long-term outcome.Results A total of 60 patients met criteria for super-response.One of thirteen (7.7%) CRT-SRs without NHA had all-cause death,which also occurred in 2 of 47 (4.3%) in CRT-SRs with NHA (P = 0.526).However,3 of 13 (23.1%) CRT-SRs without NHA had heart failure (HF) hospitalization,1 of 47 (2.1%) CRT-SRs with NHA had this endpoint (P = 0.040).Besides,subgroup analysis indicated that,for ischemic etiology group,CRT-SRs receiving NHA had considerably lower incidence of HF hospitalization than those without NHA (0 vs.75%,P = 0.014),which was not observed in non-ischemic etiology group (2.6% vs.0,P = 1.000) during long-term follow-up.Conclusions Our study found that for ischemic etiology,compared with CRT-SRs with NHA,CRT-SRs without NHA were associated with a higher risk of HF hospitalization.However,for non-ischemic etiology,we found that CRT-SRs with NHA or without NHA at follow-up were associated with similar outcomes,which needed further investigation by prospective trials. 展开更多
关键词 Cardiac RESYNCHRONIZATION THERAPY Heart failure Super-responder Optimal medical THERAPY
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Study of neutron production and moderation for sulfur neutron capture therapy 预览
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作者 Meng Peng Guo-Zhu He +3 位作者 Qi-Wei Zhang Bin Shi Hong-Qing Tang Zu-Ying Zhou 《核技术:英文版》 SCIE CAS CSCD 2019年第1期59-66,共8页
Neutron capture therapy with Sulfur-33, similar to boron neutron capture therapy with Boron-10, is effective in treating some types of tumors including ocular melanoma. The key point in sulfur neutron capture therapy ... Neutron capture therapy with Sulfur-33, similar to boron neutron capture therapy with Boron-10, is effective in treating some types of tumors including ocular melanoma. The key point in sulfur neutron capture therapy is whether the neutron beam flux and the resonance capture cross section of 33S(n;α)30 Si reaction at 13.5 keV can achieve the requirements of radiotherapy. In this research,the authors investigated the production of 13.5 keV neutron production and moderation based on an accelerator neutron source. A lithium glass detector was used to measure the neutron flux produced via near threshold7 Li(p,n)7 Be reaction using the time-of-flight method. Furthermore, the moderation effects of different kinds of materials were investigated using Monte Carlo simulation. 展开更多
关键词 SULFUR NEUTRON CAPTURE THERAPY BORON NEUTRON CAPTURE THERAPY 33S(n α)3 Si resonance reaction 7Li(p n)^7 Be NEUTRON source
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Multiline treatment of advanced squamous cell carcinoma of the lung: A case report and review of the literature 预览
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作者 Xin Yang Ping Peng Li Zhang 《世界临床病例杂志》 2019年第14期1899-1907,共9页
BACKGROUND Squamous cell carcinoma (SCC) is one the most common subtypes of non-small cell lung cancer, yet the treatment options for it remain limited. Here, we report a case of advanced SCC and review the related li... BACKGROUND Squamous cell carcinoma (SCC) is one the most common subtypes of non-small cell lung cancer, yet the treatment options for it remain limited. Here, we report a case of advanced SCC and review the related literature focusing on the multiline therapy method. CASE SUMMARY We report the case of a 45-year-old man with advanced SCC who was deemed inoperable at the time of advanced SCC diagnosis. The patient had been referred to our hospital in April 2013 with complaints of a stuffy feeling in the chest, dyspnea, and pain in the right shoulder lasting for 1 mo. Physical examination found no obvious abnormalities, except for lower breath sound in the right lower lung. Laboratory data were within normal limits. Immunohistochemistry analysis of the tumor tissue showed CK5/6 (+), p63 (+), CD56 (+), and Ki-67 (+, approximately 30%), and genetic testing detected no EGFR mutation. He received a multiline treatment that included chemotherapy, radiotherapy, targeted therapy, and antiangiogenic therapy. After more than 5-year comprehensive treatment, the patient remains alive. CONCLUSION This typical case highlights the importance of appropriate multiline therapy for those patients with advanced SCC. 展开更多
关键词 SQUAMOUS cell carcinoma Chemotherapy NAB-PACLITAXEL ANAPLASTIC LYMPHOMA kinase-targeted THERAPY ANTIANGIOGENIC THERAPY
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Photodynamic therapy-triggered on-demand drug release from ROS-responsive core-cross-linked micelles toward synergistic anti-cancer treatment
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作者 Yongjuan Li Jian Hu +6 位作者 Xun Liu Yong Liu Shixian Lv Juanjuan Dang Yong Ji Jinlin He Lichen Yin 《纳米研究:英文版》 SCIE EI CAS CSCD 2019年第5期999-1008,共10页
Polymeric micelles have demonstrated wide utility for chemodrug delivery,which however,still suffer from shortcomings such as undesired drug loading,disassembly upon dilution,pre-leakage of drug cargoes during systemi... Polymeric micelles have demonstrated wide utility for chemodrug delivery,which however,still suffer from shortcomings such as undesired drug loading,disassembly upon dilution,pre-leakage of drug cargoes during systemic circulation,and lack of cancer-selective drug release.Herein,a poly(ethylene glycol)(PEG)-polyphosphoester-based,reactive oxygen species (ROS)-responsive,core-cross-linked (CCL) micellar system was developed to encapsulate both chemodrug (doxorubicin,Dox) and photosensitizer (chlorin e6,Ce6).The hydrophobic core of the micelles was cross-linked via a thioketal (TK)-containing linker,which notably enhanced the drug loading and micelle stability.In tumor cells,far-red light irradiation of Ce6 generated ROS to cleave the TK linkers and disrupt the micelle cores.As such,micelles were destabilized and Dox release was promoted,which thereafter imparted synergistic anti-cancer effect with ROS-mediated photodynamic therapy.This study provides an effective approach to realize the precise control over drug loading,formulation stability,and cancer-selective drug release using polymeric micelles,and would render promising utilities for the programmed anti-cancer combination therapy. 展开更多
关键词 core-cross-linked micelles ON-DEMAND drug release photodynamic THERAPY reactive oxygen species (ROS) RESPONSIVENESS SYNERGISTIC an ti-cancer THERAPY
Surgery with adjuvant or neoadjuvant treatment vs surgery alone for resectable pancreatic cancer: A network meta-analysis 预览
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作者 Pu Shen Kai-Jun Huang +2 位作者 Chuan-Zhao Zhang Li Xiao Tao Zhang 《世界荟萃分析杂志》 2019年第6期309-322,共14页
BACKGROUND Pancreatic cancer is one of the most common and lethal malignancies worldwide. The common treatment options for resectable pancreatic cancer include surgery alone, neoadjuvant chemotherapy (CT), neoadjuvant... BACKGROUND Pancreatic cancer is one of the most common and lethal malignancies worldwide. The common treatment options for resectable pancreatic cancer include surgery alone, neoadjuvant chemotherapy (CT), neoadjuvant chemoradiotherapy (CRT), adjuvant CT, and adjuvant CRT. However, the optimal treatment is still controversial. AIM To identify the most effective approach for pancreatic cancer using network meta-analysis. METHODS Eligible studies were searched from PubMed, MEDLINE, EMBASE, Cochrane database, and Google scholar. We searched and included randomized controlled trials reporting on neoadjuvant and adjuvant therapies. For direct comparisons, standard pairwise meta-analysis was performed using the inverse variance DerSimonian-Laird random-effects model. For indirect comparisons, Bayesian network meta-analysis was used to combine direct and indirect evidence. We used relative hazard ratios (HRs) to estimate death difference of different treatments, and relative odds ratios (ORs) for toxic effects. Treatment effects were ranked based on their efficacy for improving survival or reducing toxicity using rankogram. The quality of evidence of estimates from direct comparison and network meta-analysis was evaluated following the GRADE approach. RESULTS We included 13 high quality trials with 1591 participants in this network metaanalysis. Compared with surgery alone [pooled HR = 0.7, 95% confidence interval (CI): 0.62-0.79] and surgery with adjuvant CRT (pooled HR = 0.6, 95%CI: 0.54-0.72), surgery with adjuvant CT had a higher rate of overall survival. In contrast, standard pairwise meta-analysis showed a statistically significant survival advantage of surgery with adjuvant CT compared with surgery alone (pooled HR = 0.75, 95%CI: 0.63-0.89;P < 0.001). Rankogram showed that surgery with adjuvant CT was most likely to rank the best in terms of overall survival (probability: 94.2%), followed by surgery alone (probability: 5.8%). No significant differences in overall toxicity or haematological toxicity were found bet 展开更多
关键词 Pancreatic cancer SURGERY Network meta-analysis ADJUVANT THERAPY NEOADJUVANT THERAPY
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Cell Therapy: A New Era of Disease Intervention 预览
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作者 Ling Lu Zhigang Tian Xuehao Wang 《工程(英文)》 2019年第1期3-4,共2页
Cell therapy has been developing rapidly in recent years, and has brought forward unique perspectives, methods, and means for curing human diseases. Following surgery, chemotherapy, and radiotherapy, cell therapy is k... Cell therapy has been developing rapidly in recent years, and has brought forward unique perspectives, methods, and means for curing human diseases. Following surgery, chemotherapy, and radiotherapy, cell therapy is known as the “fourth weapon” in malignant tumor treatment. Significant progress has also been made in the use of cell therapy to treat tissue injuries, genetic diseases, and diabetes. In fact, cell therapy is not only a hot topic in experimental and clinical research, but also a target of industry. According to the 2017–2021 report by Technavio, an internationally renowned market research company, the global cell therapy market is expected to grow at a compound annual growth rate of 23.27% between 2017 and 2021, up to 120 billion USD by 2021. Cell therapy technology has provided new solutions for serious diseases such as malignant tumors, and has become the hope of patients fighting a losing battle with disease. In this context, Engineering, the official journal of the Chinese Academy of Engineering (CAE), has published a special issue on cell therapy. This issue is composed of eight reviews and treatises on cell therapy that cover different aspects of this field. The editorial board of this special issue is deeply grateful to all the authors, reviewers, and editors who made this special issue possible. 展开更多
关键词 CELL THERAPY DEVELOPING rapidly THERAPY to TREAT
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Two-dimensional metal-organic-framework as a unique theranostic nano-platform for nuclear imaging and chemo-photodynamic cancer therapy
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作者 Wenjun Zhu Yu Yang +5 位作者 Qiutong Jin Yu Chao Longlong Tian Jingjing Liu Ziliang Dong Zhuang Liu 《纳米研究:英文版》 SCIE EI CAS CSCD 2019年第6期1307-1312,共6页
Nanoscale metal organic frameworks (NMOFs) with porous structure and inherent biodegradability are attractive nanomedicine platforms.In addition to conventional particulate NMOFs,two-dimensional (2D) NMOFs are emergin... Nanoscale metal organic frameworks (NMOFs) with porous structure and inherent biodegradability are attractive nanomedicine platforms.In addition to conventional particulate NMOFs,two-dimensional (2D) NMOFs are emerging as a unique type of NMOFs which however have been relatively less explored for nanomedicine applications.Herein,2D NMOFs composed of Zn2+ and tetrakis(4-carboxyphenyl) porphyrin (TCPP) are fabricated and functionalized with polyethylene glycol (PEG).Compared to their particulate counterpart,such 2D NMOFs show greatly increased drug loading capacity and enhanced light-triggered singlet oxygen production,promising for chemotherapy and photodynamic therapy (PDT),respectively.Utilizing the porphyrin structure of TCPP,our 2D NMOFs could be labeled with a diagnostic radioisotope,99mTc,for single photon emission computer tomography (SPECT) imaging,which reveals efficient tumor homing of those 2D NMOFs upon intravenous injection.While offering a remarkable synergistic in vivo antitumor effect for the combined chemo-PDT,such 2D NMOFs show efficient biodegradation and rapid renal clearance.Our work presents the great promise of 2D NMOFs for nanomedicine applications. 展开更多
关键词 nanoscale metal-organic-framework TWO-DIMENSIONAL NANOSHEETS drug delivery photodynamic THERAPY combination THERAPY
Engineering of a universal polymeric nanoparticle platform to optimize the PEG density for photodynamic therapy
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作者 Xixi Yang Jie Li +4 位作者 Yue Yu Junxia Wang Dongdong Li Ziyang Cao Xianzhu Yang 《中国科学:化学英文版》 SCIE EI CAS CSCD 2019年第10期1379-1386,共8页
Nanocarrier-mediated photodynamic therapy(PDT)has attracted extensive attention due to its locoregional therapeutic effect,minimal toxicity to normal tissues,and activation of immune system capability.However,it is st... Nanocarrier-mediated photodynamic therapy(PDT)has attracted extensive attention due to its locoregional therapeutic effect,minimal toxicity to normal tissues,and activation of immune system capability.However,it is still unclear how the physicochemical properties of nanocarriers affect their PDT therapeutic efficacies,which could be very different from those for chemotherapy.Herein,to demonstrate the effect of PEG density on PDT efficacy,we synthesized a series of random polyphosphoesters(PPEs)with different PEG contents by regulating the molar ratios of these monomers,and then these PPEs were used to prepare chlorin e6(Ce6)-loaded polymeric nanoparticles with tunable PEG density.Thereafter,the PDT efficacies of these nanoparticles were carefully and comprehensively evaluated.We demonstrate that the moderate PEG density(3.01 PEG/nm~2)of nanocarrier exhibited the best PDT therapeutic efficacy in a mouse model of pancreatic cancer due to its efficient balance of prolonged circulation and tumor cellular uptake. 展开更多
关键词 PEG density photodynamic therapy polymeric nanoparticles biological effect cancer therapy
Reactivation of hepatitis B virus infection in patients with hemolymphoproliferative diseases,and its prevention 预览
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作者 Caterina Sagnelli Mariantonietta Pisaturo +3 位作者 Federica Calo Salvatore Martini Evangelista Sagnelli Nicola Coppola 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3299-3312,共14页
Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver dam... Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver damage and seldom life-threatening.Due to HBV reactivation,hepatitis B surface antigen(HBsAg)-negative/anti-HBc-positive subjects may revert to HBsAg-positive.In patients with hemo-lymphoproliferative disease,the frequency of HBV reactivation depends on the type of lymphoproliferative disorder,the individual's HBV serological status and the potency and duration of immunosuppression.In particular,it occurs in 10%-50%of the HBsAg-positive and in 2%-25%of the HBsAg-negative/anti-HBc-positive,the highest incidences being registered in patients receiving rituximab-based therapy.HBV reactivation can be prevented by accurate screening of patients at risk and by a pharmacological prophylaxis with anti-HBV nucleo(t)sides starting 2-3 wk before the beginning of immunosuppressive treatment and covering the entire period of administration of immunosuppressive drugs and a long subsequent period,the duration of which depends substantially on the degree of immunodepression achieved.Patients with significant HBV replication before immunosuppressive therapy should receive anti-HBV nucleo(t)sides as a long-term(may be life-long)treatment.This review article is mainly directed to doctors engaged every day in the treatment of patients with onco-lymphoproliferative diseases,so that they can broaden their knowledge on HBV infection and on its reactivation induced by the drugs with high immunosuppressive potential that they use in the care of their patients. 展开更多
关键词 HEPATITIS B VIRUS REACTIVATION HEPATITIS B VIRUS infection Hemolymphoproliferative DISEASES IMMUNOSUPPRESSIVE THERAPY HEPATITIS B VIRUS THERAPY HEPATITIS B VIRUS prophylasis
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Application of ozone therapy in interventional medicine
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作者 Kenan Hao Shuiying Tang +2 位作者 Huaning Xie Xinmin Li Xiaofeng He 《介入医学杂志》 2019年第1期8-11,共4页
Ozone therapy has been gradually accepted by doctors in various fields because it has been safe, convenient, and inexpensive since the twentieth century. It has been used in the treatment of various diseases with sati... Ozone therapy has been gradually accepted by doctors in various fields because it has been safe, convenient, and inexpensive since the twentieth century. It has been used in the treatment of various diseases with satisfactory results, especially in the application of interventional surgery. For lumbar disc herniation, knee osteoarthritis,tissue ischemia-reperfusion after revascularization, stroke, and cancer, ozone therapy can improve the efficacy of interventional surgery and reduce postoperative acute and chronic complications. Prospects of ozone therapy in interventional therapy and the underlying mechanisms of efficacy need further exploration. 展开更多
关键词 Ozone THERAPY INTERVENTIONAL THERAPY LUMBAR disc HERNIATION Knee OSTEOARTHRITIS Tissue ISCHEMIA-REPERFUSION Stroke Cancer
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